Designing Care Management for Hospice Transitions for Persons Living With Advanced Dementia

Официальное название

ENGAGE-D: Designing Care Management for Hospice Transitions for Persons Living With Advanced Dementia

Обзор

This study will test a care management intervention to guide end-of-life care and hospice transitions for persons with dementia and their care partners receiving home healthcare and ascertain feasibility, acceptability, fidelity, and usability of a dementia care management hospice transitions checklist. This study will also examine hospice enrollment, time to enrollment, and care partner satisfaction with the intervention. The intervention will be delivered within usual care management within a large home healthcare agency.

Подробное описание

This study has the following design: Unblinded, Non-Randomized, Single-Arm Intervention Study (Feasibility Trial). In this study, the team will pilot test the care management checklist intervention with care partners of persons with dementia. This intervention will be tested for feasibility (primary outcome), acceptability, fidelity, and usability (secondary) for in a single arm feasibility trial. The intervention will be administered (NIH Stage 1B) within usual care management for hospice transitions with care partners of PLWD. This study will also examine hospice enrollment and time to enrollment, and care partner satisfaction with the intervention.

The study population includes care partners and persons living with dementia; HHC professionals who engage in hospice transitions care management with care partners of PLWD (e.g., care managers who are nurses or social workers) and field nurses; Medical providers who engage in hospice transitions communication (e.g., home care physicians and nurse practitioners); HHC administrators who oversee and manage the delivery of care management prior to hospice transitions.

Вмешательства

• Поведенческое Dementia Care Management Checklist for Hospice Transitions
  Intervention: After appropriate care partners of hospice-eligible PLWD are identified who will be receiving the checklist intervention, care managers will perform telephonic outreach to engage them in a conversation about care needs (as they would in typical clinical practice). The telephonic outreach will be followed up with a recommendation for follow up by a medical provider who may conduct a hospice care assessment and engage the care partner in decision-making surrounding the hospice referr

Первичные конечные точки

• Feasibility of the Dementia Care Management Hospice Transitions Checklist [Срок оценки: After enrollment and study participation, we will collect feasibility data within 1 month after intervention receipt.]

Вторичные конечные точки (1)

• Acceptability of the Dementia Care Management Hospice Transitions Checklist [Срок оценки: After intervention delivery, we will collect secondary outcome data within 1 month.]

Критерии участия

Inclusion:

Care Partners and PLWD Dyad:

• Care partners of PLWD who have a diagnosis of moderate to severe dementia.
• Able to provide informed consent

HHC Professionals:

Care Managers and Field Nurses:

• Care managers who regularly engage hospice transitions with care partners of PLWD
• Age 18 or older

Medical Providers:

• Medical providers (e.g., physicians and nurse practitioners) who refer patients for hospice enrollment.
• Age 18 or older

HHC Administrators:

• Home healthcare administrators who work with the Certified Home Health Agency or the Advanced Illness Management Program that refers patients to hospice care
• Age 18 or older

Exclusion

Care Partner and PLWD Dyad

• Under age 18
• Care partners who are caring for PLWD with Mild Cognitive Impairment
• PLWD with Mild Cognitive Impairment

HHC Professionals: Care Managers, Medical Providers, Administrators

1\. Do not have experience managing hospice transitions for PLWD

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Да

Дизайн исследования

Распределение

Не применимо

Модель

Одна группа

Маскирование

Открытое

Основная цель

Поддерживающая терапия

Центры проведения

США · 1 центр

• NYU Rory Meyers College of Nursing and VNS Health — New York

Публикации

• Murali KP, Carpenter JG, Kolanowski A, Bykovskyi AG. Comprehensive Dementia Care Models: State of the Science and Future Directions. Res Gerontol Nurs. 2025 Jan-Feb;18(1):7-16. doi: 10.3928/19404921-20241211-02. Epub 2025 Jan 1. PMID 39836766
• Murali KP, Gogineni S, Bullock K, McDonald M, Sadarangani T, Schulman-Green D, Brody AA. Interventions and Predictors of Transition to Hospice for People Living With Dementia: An Integrative Review. Gerontologist. 2025 Apr 9;65(5):gnaf046. doi: 10.1093/geront/gnaf046. PMID 39903194

Идентификаторы

NCT: NCT07182357 · i24-00426

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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